NPI | 1295048866 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2258656) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 2258656) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: MA 2258656) | |
Enumeration Date | 2010-07-23 |
Last Update Date | 2023-03-15 |